Successful simultaneous resection and reconstruction of abdominal aortic aneurysm and esophageal cancer

A simultaneous resection and reconstruction of abdominal aortic aneurysm (AAA) and esophageal cancer was performed on an eighty-year-old Japanese man. In spite of his advanced age, preoperative assessments revealed that the general functions of the patient were quite satisfactory. An esophagram, endoscopy and CT scan all demonstrated the esophageal cancer to be in a relatively early stage without any lymph node metastasis, while the CT scan demonstrated an infrarenal type of fusiform abdominal aortic aneurysm with a maximum transverse diameter of 7.0 cm. A simultaneous resection and reconstruction of both the AAA and esophageal cancer was performed on August 8, 1991. First, the operation for AAA was done through a retroperitoneal approach, and next, a resection and reconstruction of the esophageal cancer was performed with a right thoracotomy and laparotomy using the gastric tube as an esophageal substitute. The postoperative course was uneventful except for a temporary purulent discharge through the mediastinal drain. The patient was discharged on the 56th postoperative day. Therefore, when the general conditions are considered to be tolerable for operation, such a simultaneous operation may be indicated even inpatients of advanced age by utilizing isolated approaches and taking great care.